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Congenital HyperinsulinismPhase 2NCT04538989

An Open-Label Multiple Dose Study of RZ358 in Patients With Congenital Hyperinsulinism

A Phase 2 study testing RZ358 Sequential Group Cohort 1, RZ358 Sequential Group Cohort 2 and RZ358 Sequential Group Cohort 3 in people with Congenital Hyperinsulinism, run by Rezolute at 17 sites in 11 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The objective of this trial is to evaluate the safety, tolerability and glucose-raising effects of RZ358 in patients with Congenital Hyperinsulinism (HI). Read more about this study

Who is it for?
Ages 2 to 45 years
Conditions the study is for
Congenital Hyperinsulinism
What is being tested?
RZ358 Sequential Group Cohort 1, RZ358 Sequential Group Cohort 2 and RZ358 Sequential Group Cohort 3
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
23 participants
Where
17 sitesin 11 countries
Study dates
24 Feb 2020to 19 Aug 2022
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 2 to 45 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Male or female age 2-45 years old (except age 12-45 in US) with an established clinical diagnosis of congenital hyperinsulinism
  • Able to provide written informed consent or, as applicable, assent
  • Confirmed hypoglycemia as assessed by CGM, SMBG, and clinical evaluation, during Screening
  • Willingness to use contraception if of child-bearing potential

Who cannot join

  • Out of range blood work for study entry
  • Body Mass index outside of study entry criteria
  • History of malignancy
  • Clinically significant diseases, seropositivity for HIV, hepatitis B or C antibody
  • Use of systemic corticosteroids within 30 days before Screening
  • Known or suspected allergy to the study drug
Show all 9Show fewer
  • Recent use of an investigational drug or treatment, or participation in an investigational study
  • Pregnant or lactating women
  • History of drug abuse or excessive alcohol use

Trial locations and contacts

17 sites in 11 countries.

17 sites in 11 countries

Turkey (Türkiye)4 sites
  • Hacettepe University

    Çankaya, Ankara, 06800

  • SBÜ Gazi Yaşargil Eğitim ve Araştirma Hastanesi

    Kayapınar, Diyarbakır, 21070

  • Adana Cukurova University Balcalı Hospital

    Sarıçam, Adana

  • Erzurum City Hospital

    Yakutiye, Erzurum

Other trials in Turkey (Türkiye)

United States2 sites
  • Cook Children's Medical Center

    Fort Worth, Texas, 76104

  • The Children's Hospital of Philadelphia

    Philadelphia, Pennsylvania, 19104

Other trials in United States

Bulgaria2 sites
  • SHAT Children diseases "Prof. Dr. Ivan Mitov"

    Sofia

  • Medical University of Varna UMHAT "St. Marina"

    Varna, 9010

Other trials in Bulgaria

Israel2 sites
  • Hadassah Har Hazofim MC - Division of Pediatric Endocrinology

    Jerusalem, 90000

  • Edmond & Lilly Safra's Children Hospital

    Ramat Gan, Tel-Hashomer, 5265601

Other trials in Israel

Canada1 site
  • Research Institute of the McGill University Health Centre

    Monteral, Qubec, H4A 3J1

Other trials in Canada

Denmark1 site
  • Odense University Hospital

    Odense, 5000

Other trials in Denmark

Georgia1 site
  • LTD "Pediatric Surgery Centre"

    Tbilisi, 0122

Other trials in Georgia

Germany1 site
  • Magdeburg University Clinic Center (Otto-von-Guericke Universität)

    Magdeburg, 39120

Other trials in Germany

Russia1 site
  • Endocrinology research center

    Moscow, 117036

Other trials in Russia

Spain1 site
  • Hospital Universitari Vall d' Hebron

    Barcelona, 08035

Other trials in Spain

United Kingdom1 site
  • Great Ormond Street Hospital

    London

Other trials in United Kingdom

About this study

Official title: An Open-Label Multiple-Dose Study of RZ358 in Patients With Congenital Hyperinsulinism

The objective of this trial is to evaluate the safety, tolerability and glucose-raising effects of RZ358 in patients with Congenital Hyperinsulinism (HI).

Read the detailed description

There is a significant unmet medical need to develop new therapies aimed at preventing chronic recurrent hypoglycemia in congenital HI, the most common cause of persistent hypoglycemia in children. RZ358 is a human mAb that allosterically attenuates excessive insulin action on target cells. Therefore, RZ358 is ideally suited as a potential therapy for hyperinsulinism, and it is being developed to treat the hypoglycemia associated with diseases such as congenital HI. This is a Phase 2, multicenter, open label clinical study designed to assess the safety and efficacy of four progressively higher doses of RZ358 in separate groups of patients with hyperinsulinemic hypoglycemia due to Congenital HI, not adequately controlled with or without current standard of care. A screening period of up to 5 weeks will evaluate eligibility. Once enrolled, RZ358 will be administered bi-weekly over 8 weeks, and then patients will complete a post-treatment follow-up period of 13 weeks.

Being tested
RZ358 Sequential Group Cohort 1, RZ358 Sequential Group Cohort 2, RZ358 Sequential Group Cohort 3, RZ358 Sequential Group Cohort 4
Keywords
Hypoglycemia, Congenital Hyperinsulinism, Glucose Metabolism Disorders, Metabolic Diseases, Pancreatic Diseases, Digestive System Diseases, Hyperinsulinism
Medical subject headings
Congenital Hyperinsulinism, Hypoglycemia, Glucose Metabolism Disorders, Metabolic Diseases, Pancreatic Diseases, Digestive System Diseases, Hyperinsulinism

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • RZ358 Sequential Group Cohort 1Drug

    IV infusion for 8 weeks (3 mg/kg bi-weekly for 8 weeks)

  • RZ358 Sequential Group Cohort 2Drug

    IV infusion for 8 weeks (6 mg/kg bi-weekly for 8 weeks)

  • RZ358 Sequential Group Cohort 3Drug

    IV infusion for 8 weeks (9 mg/kg bi-weekly for 8 weeks)

  • RZ358 Sequential Group Cohort 4Drug

    IV infusion for 8 weeks (bi-weekly fixed dose-titration from 3 to 9 mg/kg for the first 4 weeks, followed by a fixed 9 mg/kg dose amount thereafter for the remaining 4 weeks)

Study groups in NCT04538989
Study groupRoleWhat they receive
RZ358 Cohort 1ExperimentalNot described
Receives: Drug: RZ358 Sequential Group Cohort 1
RZ358 Cohort 2ExperimentalNot described
Receives: Drug: RZ358 Sequential Group Cohort 2
RZ358 Cohort 3ExperimentalNot described
Receives: Drug: RZ358 Sequential Group Cohort 3
RZ358 Cohort 4ExperimentalNot described
Receives: Drug: RZ358 Sequential Group Cohort 4

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Median of Average Daily Percent Time Within a Glucose Target Range of 70-180 mg/dL (3.9-10 mmol/L) by CGM at Baseline (BL) and End of Treatment (EOT)

    The median of average daily percent time within the glucose target range 70-180 mg/dL (3.9-10 mmol/L) by CGM at Baseline and End of Treatment (EOT) is reported.

    Measured: 8 weeks

  2. Median Percent Change of Average Daily Percent Time Within a Glucose Target Range of 70-180 mg/dL (3.9-10 mmol/L) by CGM From Baseline (BL)

    The average daily percent time within the glucose target range (70-180 mg/dL) is compared from baseline to end of treatment (EOT) and the median percent change of that difference is reported.

    Measured: 8 weeks

  3. Repeat Dose Pharmacokinetics of RZ358

    All patients who received RZ358 and for whom the primary PK data was considered to be sufficient and interpretable were to be included in the PK analyses. Individual and mean plasma concentration data is summarized descriptively at the specified timepoints. The results of this study may be combined with those of other studies for analysis and modeling (e.g., population PK and PK-PD), and therefore the PK parameters are reported separately, as part of an iterative population PK approach.

    Measured: Pre dose Weeks 1,3,5,7, 1-hr post dose Week 1 and Week 7, and Follow up on Days 14, Day 28, Day 42, and Day 105

Secondary outcomes (11)
  1. Median of Average Weekly Overall, Moderate, and Severe Hypoglycemia Events by SMBG at Baseline (BL) and End of Treatment (EOT)

    The median of average weekly number of overall hypoglycemia events (<70 mg/dL [3.9mmol/L], moderate hypoglycemia events (<60 mg/dL [3.3 mmol/L] and severe hypoglycemia events (<50 mg/dL [2.8mmol/L]) by SMBG at baseline (BL) and end of treatment (EOT) is reported.

    Measured: 8 weeks

  2. Median Percent Change of Average Weekly Overall, Moderate, and Severe Hypoglycemia Events by SMBG From Baseline (BL)

    The average weekly number overall hypoglycemia events (<70 mg/dL [3.9mmol/L], moderate hypoglycemia events (<60 mg/dL [3.3 mmol/L] and severe hypoglycemia events (<50 mg/dL [2.8mmol/L]) by SMBG is compared from baseline (BL) to end of treatment (EOT) and the median percent changes of those differences are reported.

    Measured: 8 weeks

  3. Median of Average Daily Percent Time With Overall, Moderate, and Severe Hypoglycemia by CGM at Baseline (BL) and End of Treatment (EOT)

    The median of average daily percent time in overall (<70 mg/dL [<3.9 mmol/L]), moderate (<60 mg/dL [3.3 mmol/L]), and severe (<50 mg/dL [2.8 mmol/L]) hypoglycemia at baseline (BL) and end of treatment (EOT) is reported.

    Measured: 8 weeks

  4. Median Percent Change of Average Daily Percent Time With Overall, Moderate, and Severe Hypoglycemia by CGM From Baseline (BL)

    The average daily percent time in overall (<70 mg/dL [<3.9 mmol/L]), moderate (<60 mg/dL [3.3 mmol/L]), and severe (<50 mg/dL [2.8 mmol/L]) hypoglycemia is compared from baseline (BL) to end of treatment (EOT) and the median percent changes of those differences are reported.

    Measured: 8 weeks

  5. Median of Average Daily Duration (Minutes) With Overall, Moderate, and Severe Hypoglycemia by CGM at Baseline (BL) and End of Treatment (EOT)

    The median of average duration (minutes) in overall (<70 mg/dL [<3.9 mmol/L]), moderate (<60 mg/dL [3.3 mmol/L] ), and severe (<50 mg/dL [2.8 mmol/L]) hypoglycemia by CGM at baseline (BL) and end of treatment (EOT) is reported.

    Measured: 8 weeks

  6. Median Percent Change of Average Daily Duration (Minutes) With Overall, Moderate, and Severe Hypoglycemia by CGM From Baseline (BL)

    The average duration (minutes) in overall (<70 mg/dL [<3.9 mmol/L]), moderate (<60 mg/dL [3.3 mmol/L] ), and severe (<50 mg/dL [2.8 mmol/L]) hypoglycemia by CGM is compared from baseline (BL) to end of treatment (EOT) and the median percent changes of those differences are reported.

    Measured: 8 weeks

  7. Occurrence of Hypoglycemia During Fasting Challenge

    The occurrence of hypoglycemia during a 12 Hour fasting challenge.

    Measured: 8 Weeks

  8. Median of Average Hypoglycemia Events Per Day at Each of the Specified Glucose Thresholds by CGM at Baseline (BL) and End of Treatment (EOT)

    The median of average hypoglycemia events per day at each of the specified glucose thresholds [<70, <60, and <50 mg/dL (3.9, 3.3, and 2.8 mmol/L)], by CGM at baseline (BL) and end of treatment (EOT) is reported.

    Measured: 8 weeks

  9. Median Net Change of Average Hypoglycemia Events Per Day at Each of the Specified Glucose Thresholds by CGM From Baseline (BL)

    The average hypoglycemia events per day at each of the specified glucose thresholds [<70, <60, and <50 mg/dL (3.9, 3.3, and 2.8 mmol/L)], by CGM is compared from baseline (BL) to end of treatment (EOT) and the median net changes of those differences are reported.

    Measured: 8 weeks

  10. Median of Average 8-hour Overnight Percent Time in Glucose Target Range of 70-180mg/dL by CGM at Baseline (BL) and End of Treatment (EOT)

    The median of average 8-hour overnight (12am-8am) percent time within the glucose target range (70-180 mg/dL) at baseline (BL) and end of treatment (EOT) is reported.

    Measured: 8 weeks

  11. Median Percent Change of Average 8-hour Overnight Percent Time in Glucose Target Range of 70-180mg/dL by CGM From Baseline (BL)

    The average 8-hour overnight (12am-8am) percent time within the glucose target range (70-180 mg/dL) is compared from baseline (BL) to end of treeatment (EOT) and the median percent change of that difference is reported.

    Measured: 8 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Sep 2020
  2. Study start24 Feb 2020
  3. Primary completion5 Apr 2022
  4. Study completion19 Aug 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Sequential
Masking
None (open label)
Enrolment
23 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04538989
Sponsor's protocol ID
RZ358-606
Status last verified
May 2025
First submitted
21 Aug 2020
Last updated
28 May 2025
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Demirbilek H, Melikyan M, Iotova V, Galcheva S, Ozbek MN, Dastamani A, Kheladze N, Mazor-Aronovitch K, Clemente M, Empting S, Mohnike K, Christesen HT, Thornton PS, De Leon DD, Hood D, O'Boyle E, Roberts BK. Global, multi-center, repeat-dose, phase 2 study of RZ358 (ersodetug), an insulin receptor antibody, for congenital hyperinsulinism. Med. 2025 Jun 13;6(6):100611. doi: 10.1016/j.medj.2025.100611. Epub 2025 Mar 18.

    PubMed 40107271

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing RZ358 Sequential Group Cohort 1, RZ358 Sequential Group Cohort 2 and RZ358 Sequential Group Cohort 3 in people with Congenital Hyperinsulinism, run by Rezolute at 17 sites in 11 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 28 May 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 17 sites in Turkey (Türkiye), United States, Bulgaria, Israel, Canada and 6 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 28 May 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Median of Average Daily Percent Time Within a Glucose Target Range of 70-180 mg/dL (3.9-10 mmol/L) by CGM at Baseline (BL) and End of Treatment (EOT) (time frame: 8 weeks). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04538989, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 May 2025.

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